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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN -(Page I of 2) TYPE OF ACTION ❑ 1. NEW PLAN LX1 2. CHANGE OF INFORMATION 4x"� PLAN TYPE [ 1. MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 491"2 (Check one item only) ❑ 2. THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S) L FACILITY INFORMATION FACILITY ID # (Ageac7+ Use Onh) I BUSINESS NAME (Same as FACILITY NAME) (,p S.TA-TW J 4 $?.ipcl_S 3._ BUSINESS SITE ADDRESS 1 �, W><<5fm LZpt`e Il'3' C1 b"- I(". II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing, preventive maintenance, and calibration of monitoring equipment (e.g., sensors, probes, line leak detectors, etc.) must be performed at the frequency specified by the equipment manufacturers' instructions, or annually, whichever is more frequent, and that such work must be performed by qua]ifi(d personnel. 23 CCR §2632.2634.2638.2641) MONITORING EQUIPMENT IS SERVICED �( I. ANNUALLY Q ❑ 99. OTHER (Specify): 41("3° .rx"3b 111. MONITORING LOCATIONS Q t. NEW SrrE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. bD 2. SITE PLOT PLAN/MAP PREVTOUSLY sulaNw TED. (23 CCR §2632, 2631)4x1.4 IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 1. CONTINUOUS ELECTRONIC TANK MONITORING OFANNULAR (INTERSTITIAL) SPACE(S) OR SECON-DARY CONTAINMENT mxl5 VAULT(S) WITH AUDIBLE AND VISUAL ALARMS. (23 CCR §2632,2634) SECONDARY CONTAINMENT IS: ®a. DRY ❑ b. LIQUID FILLED ❑ c. PRESSURIZED ❑ d. UNDER VACUUM PANFI.. MANl TACTURER: 4•x --- - - ---s--`'v^r ---- ------------- - LEAKSENSOR MANUFACTURER: !IL� MODEL#(S): % Cj LP r1<D - ❑ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR STNGIT WALL TANK(S). (23 CCR §2643) 4W7 I PANEL MANUFACTURER: 41Y"12 MODEL #: 490.13 IN -TANK PROBF. MANUFACTURER: 49714 MODEL #(S): 4x 15 LEAK I EST FREQUENCY- ❑ a. CONTINUOUS ❑ b. DA[LY/NIGHTLY ] c. WEEKLY ax"Ic ❑ d. MONTHLY ❑ e. OTHER (Specifi•): 'x1-17 -- PROGRAMMED TESTS: ❑ a 0.1 g.p.h. Q b. 0.2 g.p.h. ❑ c, OTHER (Specifg): 4•x1 -1•r Q 3 MONTHLY STATISTICAL INVENTORY RECONCILIATION (23 CCR §2646.1): ❑ 4 WEEKLY 1IANUAL TANK GAUGING (NITG) (23 CCR §2645). TESTING PERIOD: ❑ a. 36 HOURS ❑ b. 60 HOURS 4•x"21 ❑ 5 TANK INTEGRITY TESTING (23 CCR §2613.1): 4a"23 TESTFRE LENCY � a ANNUALLY ❑ b. BIENNIALLY c. OTHERS ciR-: Q ❑ (Pe ) 4x"24 4x"29 El 99. OTHER (Specify):- - -- - _-- - 4x 26 V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check :111 that apply) I. CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 41x0-29 VISUAL ALARMS. 423 CCR §2636) SECONDARYCONTA[NMENT IS: 2Ca. DRY ❑b. LIQUID FILLED ❑c. PRESSURIZED ❑d_ UNDER VACUUM 490-N PANEL MANUFACTURER:awi.31 MODEL it ��/�. Q-ta�T f SLS 35D -19U-3' 4x1-31 _ LEAK SENSOR MANUFACTURER: VG' Fpp(L_ CiAUT #(S) -71(#3 � �Z3 4x"33__ _- -- -_ _- _MODEL _ _- - PIPING LEAK ALARM 7R4GGERS AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN. IRI a. YES ❑ b. NO 4•x734 FAILURE'DISCONNEC :"ION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN [9 a. YE -S ❑ b. NO 4/"•35 El 2. MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTNELY PERFORMS 3.0 g.p.b. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUC"T FLOW WHEN A LEAKISDETECTED 23 CCR 263 MLI.DMANIIFACTURER(S): 49737 MODEL#(S) 4x"3e ® 3 ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g p.h. LEAK TESTS (23 CCR §2636) 490-39 1 LLUMANUFACTURER(S) 1le.E%aQ 5±1tK€2'' -- PROGRAMMED IN LINL- LEAK TEST: ❑ 1. MINIMUM MONTHLY 0.2 g.p.h. ❑ 2. MINIMUM ANNUAL 0 I g.p.h. ELLD DETECTION DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. a. YES ❑ b. NO 4'JI"3 ELLD FAILURE/DISCONNECTION TRIGGERS .AUTOMATIC PUMP SHUTDOWN. ® a. YES ❑ b. NO 490-44 4. PIPE INTEGRITY TESTING 4x745 TEST FREQUENCY ❑ a. ANNUALLY ❑ b. EVERY3 YEARS ❑ c. OTHER(Specify) 490.4(,41x1.47 El 5. VISUAL PIPE MONITORING. - 4x74s' FREQUENCY ❑ a. DAILY ❑ b. WEEKLY ❑ C. MIN. MONTHLY &EACH T1 ME SYSTEM OPERATED- 4x1.49 - AIIOam Cor mon lloringol urtunw em %gB gRKrawr luel pipng on 1y 1'a Hs(.- §252H1.5[bx3) ❑ 6. SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR §2636(a)(3)1. 4m-50 L 7. NO REGULATED PIPING PER HEALTH AND SAFETY CODE, DIVISION 20, CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM I 49(4$1 ❑ 99. OTHER (Specifv) nx si UPCF UST -D (1212007) 1/4 Z -d L=-99�-60Z 141AA eoue-'A�e� d6b 90 60 2 Uer